The College supports the intent of the bill to tackle high competition ratios for training places and ensure a sustainable NHS workforce. As we have consistently highlighted, ophthalmology has one of the highest competition ratios of any training programme and chronic workforce shortages.
However the Bill is unlikely to deliver these objectives for ophthalmology without policy changes. As the legislation enters committee stage this week in the House of Lords, we therefore support amendments and future approaches that will:
- Ensure increases in specialty training places, backed by appropriate resourcing to deliver training. Challenges that UK graduates face accessing Ophthalmic Specialist Training (OST) are overwhelmingly due to the fact that the number of ophthalmology training places has barely increased over the decade, despite numbers emerging from medical school rising steadily. The proportion of those in OST who are international medical graduates (14%) has changed little in recent years.
- Deliver fair transition and future arrangements for international medical graduates (IMGs) applying for training programmes, many of whom will already have significant NHS service and a demonstrated commitment to their chosen specialty.
- Strengthen existing progression routes for IMGs in specialty, associate specialist and specialist – or SAS – and locally employed roles, such as nationally consistent Ophthalmic Local Training. IMGs are and will remain a vital part of the ophthalmology workforce so it is imperative that structured routes for career progression are in place to create fulfilling careers, improve retention and increase the capacity of ophthalmology services.
We will engage with the Bill and other key government initiatives, such as the 10 Year Workforce Plan and Medical training review, in line with these three priorities to ensure we put in place a sustainable ophthalmology workforce that can better meet patient need.